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Anatomy > Neck, axilla and breast > Flashcards

Neck, axilla and breast Flashcards

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1
Q

Label the fascia of the neck

A

1= prevertebral fascia
2=Platysma
3=pretracheal fascia
4=Investing layer
5=Sternomastoid
6=Carotid sheath

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2
Q

Describe the attachments, innervation and action of the sternocleidomastoid muscle

A

Attachments -
Superiorly : lateral surface of mastoid process of temporal bone & nuchal line ; inferiorly: manubrium of sternum , medial third of clavicle

Innervation - spinal accessory nerve (CN XI); C2 and C3 (pain and proprioception)

Action - lateral flexion of neck , chin up and down , accessory muscle of respiration

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3
Q

Describe the location, innervation and function of the trapezius muscle

A

Location - posterior border of posterior triangle

Attachments - superiorly the nuchal ligament, occipital protuberance, spinous processes of C7-T12; inferiority the clavicle and scapula

Innervation- spinal accessory nerve (CN XI) ; C2 and C3 (pain and propioception)

Fucntion - elevate retract and rotate the scapulae

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4
Q

what is the clinical relevance of the scalene muscles

A

The brachial plexus and subclavian artery pass between the anterior and middle scalenes. The subclavian vein and phrenic nerve pass anteriorly to the anterior scalene as the muscle crosses over the first rib.

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5
Q

Name the 2 neck triangles and their subdivisions

A

Anterior triangle :

  • Submental
  • Submandibular
  • Carotid
  • muscular

Posterior triangle:

  • occipital
  • subclavian
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6
Q

What forms the superior/lateral/medial borders of the anterior triangle

A

Superior - mandible
Lateral - sternocleidomastoid muscle
Medial - anterior midline of neck

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7
Q

What anatomical landmarks are structurally significant when inserting a central venous catheter in the neck region?

A

catheter can be inserted either in internal jugular vein or the subclavian Veins

subclavian veins pass anterior to first rib

phrenic nerves/anterior scalene pass very close to the IJV and SCV

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8
Q

Muscular triangle boundaries and contents *

A

The muscular triangle contains some muscles and organs – the infrahyoid muscles, the pharynx, and the thyroid, parathyroid glands.

The boundaries of the muscular triangle are:

  • Superiorly – hyoid bone.
  • Medially – imaginary midline of the neck.
  • Supero-laterally – superior belly of the omohyoid muscle.
  • Infero-laterally – inferior portion of the sternocleidomastoid muscle.

More of a trapezium than a triangle

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9
Q

The external jugular vein passes above the

A

Sternocleidomastoid muscle

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10
Q

Submandibular triangle boundaries and contents

A

Boundaries :

Superiorly – body of the mandible.

Anteriorly – anterior belly of the digastric muscle.

Posteriorly – posterior belly of the digastric muscle.

Contents :

submandibular gland
facial artery and vein
submandibular lymph nodes - drains tongue mouth
salivary gland
Hypoglossal nerve (CN XII)

mylohyoid nerve

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11
Q

Carotid triangle contents and boundaries

A

Boundaries - posterior belly of digastric muscle, superior belly of omohyoid, SCM

Content:

Carotid sheath- common carotid artery, internal jugular vein, vagus nerve
Deep cervical lymph nodes
Hypoglossal nerve (CN XII)
Cervical plexus

thryoid gland

larynx/pharynx

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12
Q

Submental triangle boundaries and contents

A

Found just below chin

Boundaries : inferiorly, the hyoid bone; laterally by the right and left inferior bellies of the digastric muscles ; the apex is at the mandibular symphysis ; roof is formed by the mylohyoid bones

Content:
submental lymph nodes

anterior jugular vein ; facial artery and veins

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13
Q

pancoast tumour; what is it and describe the possible complications

A

Cancers that start in the apex of the lung and spread to : Upper ribs/nerves in upper thorax and neck/nerves near spinal cord/blood vessels supplying the upper limb

most are a non small cell cancer (squamous cell cancer arising from cells lining the airway)

can result in compression of brachial plexus or Horner syndrome

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14
Q

What does the prefix -omo mean?

A

Shoulder

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15
Q

What does jugular mean

A

Throat

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16
Q

Describe the hyoid bone

A

Not attached to another bone - suspended by muscles and ligaments

Attachments for neck and tongue muscles

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17
Q

Label the superior view of the atlas (C1)

A
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18
Q

Label the inferior view of the atlas

A
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19
Q

Describe the articulation between the atlas and axis articulation

A

The Atlantoaxial joint is composed of three synovial joints: one median atlantoaxial joint and two lateral atlantoaxial joints.

Lateral atlanto-axial joints (x2) – formed by the articulation between the inferior facets of the lateral masses of C1 and the superior facets of C2. These are plane type synovial joints.

Medial atlanto-axial joint – formed by the articulation of the dens of C2 with the articular facet of C1. This is a pivot type synovial joint.

The transverse ligament joins the axis and atlas

Allows the rotation of the neck left and right

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20
Q

What are the 3 main features of most cervical vertebrae

A

Triangular vertebral foramen.
Bifid spinous process – this is where the spinous process splits into two distally.
Transverse foramina – holes in the transverse processes. They give passage to the vertebral artery, vein and sympathetic nerves.

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21
Q

label these three structures; indicate the point of entry for an emergency cricothyroidotomy

A 
1 = hyoid bone
2= thyroid cartilage 
3= cricoid cartilage
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22
Q

Identify the coloured structures

A
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23
Q

Define anterior, posterior and primary ramus

A

The anterior/ventral ramus innervates the skin and muscle on the anterior aspect of the trunk, while the posterior/dorsal ramus innervates the post-vertebral muscles and the skin of the back

The roots of the brachial plexus are the anterior ramii

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24
Q

Label the structures in the root of the neck

A

Phrenic nerve anterior to anterior scalene
Subclavian artery posterior to anterior scalene

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25
Contents of the vertebral artery triangle
Carries the vertebral artery and phrenic nerve
26
Borders of the axilla
27
Identify the muscles here
28
Contents of axilla
Brachial plexus Axillary arteries, veins and lymph nodes Bicep and corachobrachialis tendons
29
What is the most common direction in which dislocation occurs? Which nerve is in most danger when the shoulder joint is dislocated ?
Anterior dislocation Axillary nerve
30
The axillary artery passes under and over which muscles ?
Under the pec minor Over the teres major
31
Identify the axillary artery and vein
32
The subclavian vein branches into the ____ \_\_\_\_ and the _____ \_\_\_\_\_
Cephalic vein and axillary vein
33
Label the breast
The lobules are the milk glands that produce milk the lactiferous ducts transfer the milk from the lobules to the nipple suspensory ligaments attach the breast to the dermis and pectoral fascia as well as separating the secretory lobules of the breast
34
What vessels will supply and drain the breast tissue
Superior thoracic artery Internal mammary artery Acromiothoracic artery Ancillary artery Thoracodorsal artery Axillary vein Lateral thoracic vein Internal mammary vein
35
Posterior triangle boundaries, roof and floor
Sternocleidomastoid muscle Trapezius Clavicle Roof - deep investing fascia Floor - prevertebral fascia
36
Contents of posterior triangle
Cervical plexus/brachial plexus/subclavian artery (found between mid scalene muscle and the anterior scalene muscle) External jugular vein Floor - omohyoid muscle , transverse cervical and suprascapular arteries, spinal accessory nerve (CN XI), the 3 scalene muscles , splenius capitis, levator scapulae,
37
Omohyoid muscle
in the posterior triangle region split into two bellies by a tendon. The inferior belly crosses the posterior triangle, travelling in an supero-medial direction, and splitting the triangle into two (occipital triangle and supraclavicular triangle). The muscle then crosses underneath the SCM to enter the anterior triangle of the neck.
38
Label the suprahyoid and infrahyoid muscles of the neck
39
Where does the subclavian artery become the axillary artery?
Once it passes below the clavicle it becomes the axillary artery
40
Veins of the neck
SVC —\> R and L brachiocephalic veins R and L brachiocephalic veins —\> L/R subclavian vein +L/R internal jugular vein
41
Great arteries of neck
Seen at C7
42
What are fascia
Strand or sheets of fibrous connective tissue that wrap around the organs to form compartments
43
Contents of superficial fascia
Outermost layer of fascia Subcutaneous tissue , platysma tissue and cutaneous vein,artery and nerve
44
Location/contents/boundaries of the deep investing fascia
Just below superficial fascia Encircles the neck Envelops the traps/SCM Forms the rood of the posterior triangle Pierced by cutaneous branches of cervical plexus and EJV Boundaries : Anteriorly - mandible, hyoid, sternum Posteriorly - occipital, nuchal ligament, traps
45
Location/contents of pretracheal fascia
Forms visceral compartment - contains trachea, thyroid, recurrent laryngeal nerve, oesophagus, parathyroid gland
46
summarise the branches of the brachial plexus and the muscles they innervate
47
define the terms anterior (ventral) and posterior (dorsal) primary ramus​
A primary ramus is a branch of a spinal nerve​
48
summarise the brachial plexus
remember to drink cold beer
49
groups of ventral rami
Cervical plexus (C1-C5) supplies head & neck​ ​ Brachial plexus (C5-T1) supplies upper limb​ ​ Nerves of the trunk (T1-L1) supply trunk​ ​ Lumbosacral plexus (L1-S3) supplies trunk & lower limb​ ​ Sacrococcygeal plexus (S3-S5) supplies pelvis & lower trunk​
50
location of cervical plexus
located in posterior triangle of neck halfway up SCM, and within prevertebral fascia ; derived from cervical rami C1-C4
51
Label the cervical spine
52
Nerves of cervical plexus
53
Name the nerves of the cervical plexus innervating each of the highlighted areas and the vertebral origin
54
Label this diagram of the superficial fascia
55
Platysma - attachments, innervation and actions
Attachments - superiorly : inferior border mandible, skin and subcutaneous tissue of lower face. Inferiorly : fascia covering superior parts of pec major and deltoid Innervation - cervical branch off the facial nerve (CN VII) Actions - draws corners of mouth inferiorly and widens in expression of sadness and fright
56
label the structures within the neck at level of C7
57
label the infra hyoid muscles
58
label the clavicle; describe the superior and inferior surfaces
superior surface is mostly subcutaneous ; inferior surface - attachment of subclavius muscle and site of important ligaments attaching it to the coracoid process
59
label the mandible
60
label the hyoid bone
61
62
Label the arteries of the neck
63
Identify the structures X and Y of the brachial plexus
64
Identify the muscles of the posterior wall
65
Boundaries of delta pectoral triangle
Clavicle Deltoid Clavicular head of deltopectoral triangle The deltopectoral triangle is a palpable hollow area
66
Lymph vessels drain into the
Venous system
67
What causes Horner syndrome and what are the symptoms?
Lesion of a sympathetic trunk in the neck * Pupillary constriction resulting from paralysis of the dilator pupillae muscle. * Ptosis (drooping of the superior eyelid), resulting from paralysis of the smooth (tarsal) muscle intermingled with striated muscle of the levator palpebrae superioris. * Sinking in of the eyeball (enophthalmos), possibly caused by paralysis of smooth (orbitalis) muscle in the floor of the orbit. * Vasodilation and absence of sweating on the face and neck (anhydrosis), caused by a lack of sympathetic (vasoconstrictive) nerve supply to the blood vessels and sweat glands.
68
Pressure on the brachial plecuts can cause specific symptoms ; describe them
Severe pain in the shoulder or scapula pain in the arm or weakness of the hand in the affected side
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70
The shoulder joint is formed by articulation between the ____ \_\_\_\_ with the ____ \_\_\_\_ what type of joint is it and what kind of cartilage covers it?
Humeral head ; glenoid fossa (of scapula) synovial joint; covered by hyaline cartilage
71
Why should special attention be given to the parathyroid glands during a thyroidectomy
parathyroid glands are situated behind the lateral lobes of thyroid high risk of being damaged/removed during surgery as parathyroid responsible for increase [Ca2+], remove results in hypocalcaemia hypocalcaemia symptoms ; tetanus, muscle cramps, tingling of fingers/toes/mouth
72
Which nerve are close to the (a) superior thyroid artery and the (b) inferior thyroid artery and why Is this clinically relevant
A) external laryngeal nerve b) recurrent laryngeal nerve important to not damage during thyroid surgery as this can cause problems with speech and Swallowing
73
describe carotid sinus hypersensitivity
Exaggerated response to carotid sinus baroreceptor stimulation = HR/BP dangerously fall = fainting and falls (particularly dangerous in older patients) often in people with atheroscleoris
74
Where on the axillary artery must a blockage occurs for the anastomosis to maintain an uncompromising supply of blood to the rest of the upper limb?
Between 1st part of the subclavian artery and 3rd part of axillary artery
75
Define anastomosis
Communication between neighbouring vessels via branching pre-capillaries
76
Label the axial projection of the shoulder joint
77
Damage to the C5/6 roots of brachial plexus symptoms
Loss of lateral rotation of shoulder loss of abduction and elbow flexion reduced ability to extend wrist sensory loss at thumb and index
78
symptoms of damage to C8/T1
Loss of finger extension finger and thumb flexion sensory loss of ring/little finger Horner syndrome may occur - drooping of eyelid/absence of sweat in cheek/excess pupil constriction/posterior displacement of eye
79
Which root and trunks of the brachial plexus will be most likely to be affected by a Pancoasts tumour?
C5/6 in early disease = arm and shoulder pain C8/T1 in late disease = horners syndrome
80
some people are born with an extra rib above the first rib called the cervical rib Describe the possible complications
Thoracic outlet syndrome via compression of C8/T1
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The lateral chord forms branches off into
Lateral pectoral nerve musculocutaneus nerve lateral root of median nerve
90
The posterior chord branches off into
Superior subscapular nerve, thoracodorsal nerve inferior subscapulnar axillary nerve radial nerve
91
the medial chord branches off into
Medial pectoral medial cutaneous nerves of arm and forearm medial root of median nerve ulnar nerve

Anatomy (8 decks)

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